The Calibra® Universal Self-Adhesive Resin cement opaque shade was prepared for use by bleeding the dual-barrel automix syringe prior to attaching a mix tip to ensure both base and catalyst were expressing evenly. Then, the mix tip was installed and a small amount of material was dispensed onto a mixing pad to again ensure adequate mix of the cement components. A thin, uniform layer of cement was dispensed onto the entire internal surface of the restoration directly from the mixing tip (Figure 2). The crowns were then immediately seated onto the cleaned and slightly moist preparations (Figure 3).
The buccal and palatal aspects of the restoration were tack-cured for 5 seconds using a SmartLite® Focus® Pen-Style LED Curing Light (Dentsply Sirona Restorative), initializing a gel phase (Figure 4). The cement was gently removed using an explorer; great care was taken to avoid causing gingival bleeding (Figure 5). Interproximal excess was removed by stabilizing the restorations and flossing the areas, horizontally removing the floss after each area was verified.
After successful removal of excess cement, the restorations received a 20-second light-curing from the buccal, palatal, and incisal. Final verification of interproximal contacts, occlusion, and esthetics was completed and the patient was released (Figure 6).
SARCs can offer clinical advantages over other cement categories. In clinical situations where the preparation has sufficient crown height, is not over-tapered, and can be isolated from contamination, SARCs offer convenience without sacrificing strength and esthetics. Calibra Universal offers an extended gel phase when used in both the light-activated and self-cure modes for indirect restorations. As a result, clinicians can now better leverage SARC technology without the stress of cleaning up excess cement.
Jason H. Goodchild, DMD, is an employee of Dentsply Sirona Restorative.
1. Rosenstiel SF, Land MF, Crispin BJ. Dental luting agents: a review of the current literature. J Prosthet Dent. 1998;80(3):280-301.
2. Burgess JO, Ghuman T, Cakir D. Self-adhesive resin cements. J Esthet Restor Dent. 2010;22:412-419.
3. Ferracane JL, Stansbury JW, Burke FJ. Self-adhesive resin cements—chemistry, properties and clinical considerations. J Oral Rehabil. 2011;38(4):295-314.
4. Makkar S, Malhotra N. Self-adhesive resin cements: a new perspective in luting technology. Dent Update. 2013;40(9):758-768.
5. Zorzin J, Belli R, Wagner A, et al. Self-adhesive resin cements: adhesive performance to indirect restorative ceramics. J Adhes Dent. 2014;16(6):541-546.
6. Weiser F, Behr M. Self-adhesive resin cements: a clinical review. J Prosthodont. 2015;24(2):100-108.
7. Rodrigues RF, Ramos CM, Francisconi PA, Borges AF. The shear bond strength of self-adhesive resin cements to dentin and enamel: an in vitro study. J Prosthet Dent. 2015;113(3):220-227.
8. Behr M, Hansmann M, Rosentritt M, Handel G. Marginal adaptation of three self-adhesive resin cements vs. a well-tried adhesive luting agent. Clin Oral Investig. 2009;13(4):459-464.
9. De Munck J, Vargas M, Van Landuyt K, et al. Bonding of an auto-adhesive luting material to enamel and dentin. Dent Mater. 2004;20(10):963-971.
10. Duarte S Jr, Botta AC, Meire M, Sadan A. Microtensile bond strengths and scanning electron microscope evaluation of self-adhesive and self-etch resin cements to intact and etched enamel. J Prosthet Dent. 2008;100(3):203-210.
11. Aguiar TR, de Oliveira M, Arrais CA, et al. The effect of photopolymerization on the degree of conversion, polymerization kinetic, biaxial flexure strength, and modulus of self-adhesive resin cements. J Prosthet Dent. 2015;113(2):128-134.
12. da Silva Fonseca AS, Mizrahi J, Menezes LR, et al. The effect of time between handling and photoactivation on self-adhesive resin cement properties. J Prosthodont. 2014;23(4):302-307.
13. Piwowarczyk A, Schick K, Lauer HC. Metal-ceramic crowns cemented with two luting agents: short-term results of a prospective clinical study. Clin Oral Investig. 2012;16(3):917-922.
14. Azevedo CG, De Goes MF, Ambrosano GM, Chan DC. 1-year clinical study of indirect resin composite restorations luted with a self-adhesive resin cement: effect of enamel etching. Braz Dent J. 2012;23 (2):97-103.
15. Blatz MB, Mante FK, Saleh N, et al. Postoperative tooth sensitivity with a new self-adhesive resin cement—a randomized clinical trial. Clin Oral Investig. 2013; 17(3):793-798.
16. Shetty RM, Bhat S, Mehta D, et al. Comparative analysis of postcementation hypersensitivity with glass ionomer cement and a resin cement: an in vivo study. J Contemp Dent Pract. 2012;13(3):327-331.
17. Saad Del-D, Atta O, El-Mowafy O. The postoperative sensitivity of fixed partial dentures cemented with self-adhesive resin cements: a clinical study. J Am Dent Assoc. 2010;141(12):1459-1466.
18. Manhart J, Chen H, Hamm G, Hickel R. Buonocore Memorial Lecture. Review of the clinical survival of direct and indirect restorations in posterior teeth of the permanent dentition. Oper Dent. 2004;29(5):481-508.
For more information, contact:
Dentsply Sirona Restorative
About the Author
Jason H. Goodchild, DMD
Clinical Associate Professor
Department of Oral Medicine
University of Pennsylvania School of Dental Medicine
Clinical Education Manager
Dentsply Sirona Restorative